胶质瘤生物学特性与相毗邻纤维束状态的相关性研究

The relationship between the biological behavior of giiomas and the state of adjacent fiber tracts

目的探讨胶质瘤生物学特性与相毗邻纤维束状态的相关性。方法对24例经手术及组织病理学证实的胶质瘤患者，术前行常规MRI、DTI检查．重建出肿瘤周围纤维束三维图．获得瘤周纤维束的状态：被推移、浸润或者破坏。应用SP免疫组织化学方法对瘤实体标本的MMP-9、CD44、VEGF、Ki-67的表达进行检测分析。结果VEGF与Ki-67的表达在高级别胶质瘤中高于低级别胶质瘤（P（0．05），而MMP-9与CD44的表达在低级别和高级别胶质瘤中均无显著性差异（P〉0．05）。高级别胶质瘤周围的纤维束较低级别胶质瘤其被侵犯的程度重（P〉0．05）。此外，高表达VEGF或者Ki-67的胶质瘤，瘤周纤维束被侵犯的程度较低表达的胶质瘤重（P〈0．05）；而CD44与MMP-9的表达与瘤周纤维束的状态则不具有相关性（P〉0．05）。结论DTI可清楚显示胶质瘤与周围白质纤维的解剖位置关系及纤维束病理状态．胶质瘤的病理等级和增殖性可影响瘤周纤维束的状态，而其浸润性对瘤周纤维束的状态影响不大．有助于在影像学上对胶质瘤的生物学特性进行判断，指导治疗方案的制定。

Objective To study the relationship between the biological behavior ofgliomas and the state of adjacent fiber tract. Methods Regular MRI and DTI were performed in 24 patients with histologically confirmed brain gliomas. The fiber tracts adjacent gliomas reconstructed with 3-dimensional, the state of fiber tracts were evaluated with displaced, infiltrated or destroyed. Reflection the infiltration of glioma of MMP-9 ,CD44 and the proliferative activity of VEGF and Ki-67 expression were evaluated by SP immunohistochemical staining method in surgical specimens. Results The expression of VEGF or Ki-67 was higher in high grade gliomas than low grade （P〈0.05） and a negative correlation （P〉0.05） between MMP-9 or CD44 expression and the grade of gliomas was found. The states of fiber tracts were damaged greatly in the periphery of high grade gliomas than low grade （P〈0.05）. Further, the states of fiber tracts were destroyed heavily in the periphery of gliomas that had higher expression of VEGF or Ki-67 （P〈0.05）. But there were poor correlation （P〉0.05） between MMP-9 or CD44 expression and the state of fiber tracts adjacent to gliomas. Conclusions The grade of and proliferation of gliomas can influence the state of fiber tracts in the periphery of gliomas but the infiltration did not. It was helpful to estimate the biological behavior of gliomas on imagines and useful in deciding the therapeutic regimen.